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Aguilar O.C.,Hospital General Dr Aurelio Valdivieso | Carvallar E.R.,Hospital General Dr Aurelio Valdivieso | Martinez J.V.,Hospital General Dr Aurelio Valdivieso | Cuevas J.H.,Hospital General Dr Aurelio Valdivieso
Revista Chilena de Obstetricia y Ginecologia | Year: 2016

Objective: To determine the incidence, main indications and complications of obstetric hysterectomy in a secondary hospital care to four years to implement the program of prevention and management of obstetric hemorrhage. Methods: Descriptive study of review of clinical records, transversal, analytical and retrospective. Results: 51 cases of patients who obstetric hysterectomy (OH) was held between January 2012 to November 2015. The prevalence was 17.1/10,000. The incidence per year was 1.7 (2012), 1.7 (2013), 1.4 (2014) and 1.9 (2015) per 1000 births, respectively. The prevalence of post-cesarean OH was 25.6/10,000 while postpartum OH was 10.6/10,000. The variables that reached significance between scheduled and emergency surgery was blood loss and need for blood transfusions. The procedure is associated with anemia in the postpartum period 7 times and the main indications for the procedure were alteration abnormal placental adhesion and uterine atony. Conclusions: The prenatal diagnosis of abnormal placental adhesion, better use of blood products and surgical technique has eliminated maternal mortality by massive obstetric hemorrhage in the last four years in the General Hospital Dr. Aurelio Valdivieso.


Calvo-Aguilar O.,Ginecoobstetra especialista en Medicina Materno Fetal | Vasquez-Martinez J.,Residente de tercer ano de Ginecologia y Obstetricia | Hernandez-Cuevas J.,Hospital General Dr Aurelio Valdivieso
Ginecologia y Obstetricia de Mexico | Year: 2016

BACKGROUND: Post-cesarean hysterectomy is the most extensive procedure used during the postpartum stage. This is an indicator of quality substantially associated with extreme obstetric morbidity. OBJECTIVE: To determine the incidence, indications, and complications associated with obstetric hysterectomy in a hospital, after three years to implement the program of prevention and management of massive obstetric hemorrhage. MATERIALS AND METHODS: Observational, transversal, retrospective and descriptive study conducted from January 2011 to November 2013. We records patients who underwent obstetric hysterectomy, of any age and at any time during pregnancy were reviewed. The results are expressed as frequencies, percentages and central tendency measures. RESULTS: 38 patients were recorded with obstetric hysterectomy. We found prevalence of 18.4 per 10,000, and incidence per year of 1.7, 1.4 and 2.6 per 1,000 births for 2011, 2012 and 2013. The prevalence of post-cesarean hysterectomy was 63.05 per 10,000 while postpartum was 9.05 per 10,000 births. The only difference between scheduled and emergency surgery was operating time. The procedure is associated with anemia in postpartum 13 times and the main indications for the procedures were hypo/atony and placenta accrete. CONCLUSIONS: The prenatal diagnoses of placenta accrete and improvement in the use of blood products and surgical technique has eliminated maternal mortality by massive obstetric hemorrhage in the last three years at the General Hospital “Dr. Aurelio Valdivieso”. © 2016, Asociacion Mexicana de Ginecologia y Obstetricia. All rights reserved.


Noguera-Sanchez M.F.,Subdireccion General de Tnnovacion y Calidad | Arenas-Gomez S.,Servicio de GinecologIa y Obstetricia | Rabadan-Martinez C.E.,Hospital General Dr Aurelio Valdivieso | Antonjo-Sanchez P.,Subdireccion General de Tnnovacion y Calidad
Cirugia y Cirujanos | Year: 2013

Background: In Mexico, the maternal mortality has a diminishing rate in the country the last decades, except in the estate of Oaxaca. Oaxaca is located amongst the entities with the highest ratios of maternal mortality. Objective: To analyzed the behavior and epidemiology tendencies of 10 years period of maternal mortality at the Dr. Aurelio Valdivieso General Hospital. Methods: In a retrospective, descriptive, and transversal analysis, there were reviewed the maternal mortality files from the gynecology and obstetrics division. Three sets of variables were designed, socials, obstetrical and circumstantial. We used general and descriptive statistical tools. Results: From January first to December 3lth of 2009 it was registered 109 maternal deaths, excluding 2 non-obstetrical. Resulting in a 107 maternal deaths; divided in 75 direct maternal deaths and 32 indirect maternal deaths, the maternal mortality rate was 172.14 × 100,000 livebirths. Eighty nine maternal deaths were foreseeable (83%) and 18 were not foreseeable (17%) as was stated by the ad hoc Committee within the Dr. Aurelio Valdivieso's General Hospital. The pregnancy-related hypertension takes account for the highest pathology in relationship with maternal deaths, the low literacy and puerperium correlated for the higher risk. Conclusions: Low human development index, low literacy, were the accountable variables that confined higher mortality risk. Also was found that the higher occurrence of maternal deaths appeared during the puerperium and within hospital wards. The maternal mortality rate founded was the higher amongst the country.


Aguilar O.C.,Hospital General Dr Aurelio Valdivieso | Mendoza Y.R.C.,Hospital General Dr Aurelio Valdivieso | Cuevas M.J.H.,Hospital General Dr Aurelio Valdivieso
Ginecologia y Obstetricia de Mexico | Year: 2011

Background: In April 2009 are reported the first cases of H1N1 influenza in Mexico, presenting the first death from this cause in the city of Oaxaca in the same month. Different epidemiological reports of pandemics brought to the pregnant and high risk population for complications secondary to infection with influenza H1N1 due to immune status. Objective: describe the obstetric population infected with H1N1 influenza in the Hospital General Dr. Aurelio Valdivieso of Oaxaca. Material and method: Retrospective and observational study conducted in pregnant women with suspected infection by the virus of the influenza A/H1N1 served in the General Hospital Aurelio Valdivieso of Oaxaca, Oax in 13 patients with influenza H1N1 confirmed by RTPCR during the pandemic occurred from May 2009 to April 2010. Results: We reported 27 suspected cases of H1N1 influenza in pregnant women of which 13 were positive by RT-PCR, the cumulative incidence was 1.6 per 1000 pregnant women during the period. The fatality rate was 7.6 per hundred pregnant women affected, one case of maternal death indirectly by fluid and electrolyte imbalance occurred and the attack rate was 0.16 per 100 pregnant women, the main complication of atypical pneumonia occurred in four cases followed by three cases of preeclampsia, infants showed no defects and perinatal outcomes were good to present two cases of admission to the NICU for iatrogenic prematurity without deaths. Conclusions: H1N1 influenza infection has a high fatality rate in late pregnancy. Perinatal outcomes did not worsen the condition or management.


Aguilar O.C.,Hospital General Dr Aurelio Valdivieso | Romero A.L.F.,Hospital General Dr Aurelio Valdivieso | Garcia V.E.M.,Hospital General Dr Aurelio Valdivieso
Ginecologia y Obstetricia de Mexico | Year: 2013

Background: Vertical position is an option to delivery to which several advantages have been attributed. This research exposes its related findings. Objective: To compare obstetric and perinatal outcomes between supine and vertical position at delivery. Patients and method: We performed a randomized double-blind study including healthy women assigned to the supine or upright posture (vertical) during labor with complications following the delivery in the puerperium stage. The variables evaluated were: blood loss, pain in the second period of labor and immediate postpartum, duration of the second period of labor, perineal and vaginal tears, need to forceps implement, accommodation in position and perinatal outcome. Results: 164 patients were randomized into two groups, the vertical position (I) and the supine position (II). The losses were 5.4%, and the Caesarean rate was of 4.6%. Difference was found only for vaginal tears in the vertical posture, with a relative risk of 1.4 (CI 1.1-3.2), and shortening of the second period with a significant difference of 10 minutes on average (p < 0.05). Conclusions: The upright posture during childbirth provides no improvement in perinatal outcomes and fewer obstetric conditions. It shortens the second period of labor, but it is a risk factor for vaginal tears. The best position for birth is which offers more comfort to the patient.


Hernandez-Enriquez N.P.,Hospital General Dr Aurelio Valdivieso | Rosas-Sumano A.B.,Hospital General Dr Aurelio Valdivieso | Monzoy-Ventre M.A.,Hospital General Dr Aurelio Valdivieso | Galicia-Flores L.,Hospital General Dr Aurelio Valdivieso
Revista Mexicana de Pediatria | Year: 2016

Necrotizing enterocolitis is the most common and serious intestinal disorder that occurs in newborns, mainly in preterm infants with very low birth weight (less than 1,500 g weight with gestational age of less than 34 weeks gestation). Objective: To evaluate the effectiveness of the use of the probiotic Lactobacillus reuteri 17938 DMS, to reduce the incidence of necrotizing enterocolitis in infants with very low birth weight. Patients and methods: It was a clinical trial, controlled, randomized. There were selected infants with very low birth weight which were randomly divided into 2 groups. Group A (study group) received Lactobacillus reuteri 5 drops, equivalent to 100 million colony forming units (1 × 108CFU) daily, whether they were newborns with weight greater than 1,000 to 1,500 g. In the case of newborns with weight less than 1,000 g them 3 drops were administered Lactobacillus reuteri (60 million CFU) daily. Group B (control group) received no probiotic. Probiotic administration was for 20 days, with mixed feed in both groups. The diagnosis and classification of necrotizing enterocolitis were made of three neonatologists, who knew the group allocation. Results: 106 patients were eligible, 44 newborns were admitted to the study. The incidence of suspected necrotizing enterocolitis (1 of 24 versus 10 of 20) was significantly lower in the study group : OR 23.0 (95[%]CI 2.58 - 204.60). With a number needed to treat of 11. Conclusion: Supplementation with Lactobacillus reuteri DSM 17938 is effective in preventing necrotizing enterocolitis.


Garcia V.M.,Hospital General Dr Aurelio Valdivieso | Gomez E.B.,Hospital General Dr Aurelio Valdivieso | Santiago E.V.,Hospital General Dr Aurelio Valdivieso | Perez U.S.,Hospital General Dr Aurelio Valdivieso
Ginecologia y Obstetricia de Mexico | Year: 2011

We report the case of a 17 year old patient with partial molar pregnancy and coexistent live fetus of 13 gestational weeks diagnosed by ultrasound, which required the termination of pregnancy for maternal decompensation.


Calvo-Aguilar O.,Hospital General Dr Aurelio Valdivieso | Morales-Garcia V.E.,Hospital General Dr Aurelio Valdivieso | Fabian-Fabian J.,Hospital General Dr Aurelio Valdivieso
Ginecologia y Obstetricia de Mexico | Year: 2010

Background: Obstetric Morbidity Extreme (OME) is a promising addition to the investigation of maternal deaths and is used for the evaluation and improvement of maternal health services is defined as a severe obstetric complication that threatens the life of the pregnant woman and requires urgent medical intervention to prevent death of the mother. Objective: To identify association between diseases and obstetric morbidity Extreme. Material and method: Transversal review analytical records. We searched for codes related to conditions that could cause extreme obstetric morbidity and the indirect causes that might cause it. Results: The prevalence of OME 21 per 1000 newborns, diseases with greater association were eclampsia, liver failure and preeclampsia yielded the highest OR and statistical significance, the association of OME derived from surgery despite having a high prevalence in the analysis showed no association, in the same way if other variables showed association but had no significance and confidence intervals are below the unit that is the case of renal failure, metabolic failure and blood transfusion. Conclusions: The OME is caused by group entities specific disease (FLASOG) in most cases such as preeclampsia, eclampsia and obstetric hemorrhage.


Monzoy-Ventre M.A.,Hospital General Dr Aurelio Valdivieso | Rosas-Sumano A.B.,Benito Juárez Autonomous University of Oaxaca | Hernandez-Enriquez N.P.,Hospital General Dr Aurelio Valdivieso | Galicia-Flores L.,I.M.S.S.
Revista Mexicana de Pediatria | Year: 2015

Introduction: Transient tachypnea of the newborn is a selflimited disorder. The objective of this study was to know the usefulness of inhaled salbutamol in the clinical evolution of transient tachypnea of the newborn. Material and methods: Experimental clinical study in which salbutamol nebulizations were administered at doses of 0.10 mg/kg and 0.15 mg/kg. The study included newborns of 34 to 42 weeks gestation, hospitalized in special care newborn units of the Hospital Aurelio Valdivieso. After nebulizations, we assessed the respiratory frequency, Silverman-Anderson score, oxygen saturation, partial pressures of oxygen and carbon dioxide at 30 minutes, and at 1 and 4 hours. Results: Of the 46 newborns studied, 15 corresponded to the control group, 16 to the inhaled salbutamol at the 0.10 mg/kg dose and 15 to the 0.15 mg/kg dose. Comparison of the groups receiving salbutamol with the control group revealed an improvement in respiratory (p ≤ 0.05, with an OR: 2.29 and CI 95%: 1.191- 4.417). Conclusions: Inhaled salbutamol could modify the clinical evolution of the transient tachypnea of the newborn by improving respiratory frequency.


PubMed | Hospital General Dr Aurelio Valdivieso
Type: Comparative Study | Journal: Ginecologia y obstetricia de Mexico | Year: 2013

Vertical position is an option to delivery to which several advantages have been attributed. This research exposes its related findings.To compare obstetric and perinatal outcomes between supine and vertical position at delivery.We performed a randomized double-blind study including healthy women assigned to the supine or upright posture (vertical) during labor with complications following the delivery in the puerperium stage. The variables evaluated were: blood loss, pain in the second period of labor and immediate postpartum, duration of the second period of labor, perineal and vaginal tears, need to forceps implement, accommodation in position and perinatal outcome.164 patients were randomized into two groups, the vertical position (I) and the supine position (II). The losses were 5.4%, and the Caesarean rate was of 4.6%. Difference was found only for vaginal tears in the vertical posture, with a relative risk of 1.4 (CI 1.1-3.2), and shortening of the second period with a significant difference of 10 minutes on average (p < 0.05).The upright posture during childbirth provides no improvement in perinatal outcomes and fewer obstetric conditions. It shortens the second period of labor, but it is a risk factor for vaginal tears. The best position for birth is which offers more comfort to the patient.

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